DESCRIPTION: A goal of Healthy People 2010 is to develop more effective interventions to reduce the problem of destructive periodontal disease in the aging U.S. population. New approaches to treatment of periodontal disease are clearly needed. HMG-CoA reductase inhibitors, commonly referred to as "statins" offer promise in this realm. Statins decrease levels of matrix metalloproteinases, stimulate production of bone morphogenetic protein (BMP)-2, decrease TNF-alpha levels, and appear to reduce inflammation, all factors involved in the pathogenesis of periodontal disease. This epidemiologic study will test the hypothesis that the use of statins may ameliorate periodontal disease, as measured by tooth loss and clinical probing depth. We will take advantage of the existence of a large population with coverage for both dental and medical services through Kaiser Permanente Northwest and the availability of high quality administrative data about their dental and medical care utilization, including prescription drugs, supplemented with chart abstraction data. The study will examine two cohorts of patients, aged 40-65 with periodontal disease, evaluating the outcomes of tooth loss and changes in clinical probing depths in relation to statin use. Multivariate analyses controlling for other factors affecting the course of periodontal disease (e.g., smoking, diabetes, and other periodontal treatments) will be conducted, with statin use as a time-dependent covariate, if an association is found, this will set the stage for future, prospective studies to evaluate statin use as a treatment modality for periodontal disease.